Indications for absorbable steroid-eluting sinus implants: Viewpoint via the Delphi method

• Type of Material: Article
• Authors: Victoria S Lee, University of Illinois; Prayang Patel, Rutgers New Jersey Medical School; Daniel O'Brien, University of Alberta; George A Scangas, Harvard Medical School; Raewyn G Campbell, Macquarie University; Rakesh Chandra, Vanderbilt University; Greg E Davis, Proliance Surg Seattle & Puyallup WA; Joseph K Han, Eastern Virginia Medical School; Christoper H Le, University of Arizona; Jivianne Lee, University of California Los Angeles; Amber U Luong, Univ Texas Hlth Sci Ctr Houston; David M Poetker, Medical College of Wisconsin; Hassan Ramadan, West Virginia University; Michael Setzen, Michael Setzen Otolaryngol PC; Kristine Smith, University of Manitoba; Sarah Wise, Emory University; Jennifer Villwock, University of Kansas; Elisabeth Ference, University of Southern California
• Language: English
• Date: 2022-07-05
• Publisher: WILEY
• Publication Version: Final Published Version
• Copyright Statement: © 2022 The Authors. International Forum of Allergy & Rhinology published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngic Allergy and American Rhinologic Society
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1002/alr.23044
• Title of Journal or Parent Work: INTERNATIONAL FORUM OF ALLERGY & RHINOLOGY
• Volume: 12
• Issue: 10
• Start Page: 1225
• End Page: 1231
• Keywords: SINUVA; OUTCOMES; Life Sciences & Biomedicine; Otorhinolaryngology; Science & Technology; steroid-eluting implants; EFFICACY; PROPEL; SURGERY; endoscopic sinus surgery; RESOLVE; IN-OFFICE TREATMENT; SAFETY
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Absorbable steroid-eluting sinus implants provide targeted corticosteroid release over a sustained period and are designed to prevent both undesirable adhesion formation and sinus ostia restenosis. Here, we highlight the key evidence of these implants to date and query a group of experts via a Delphi process on the indications and optimal timing for intraoperative or in-office placement of these implants. Six of a total of 12 statements reached consensus and were accepted. Overall, experts largely agree that intraoperative or in-office use of steroid-eluting stents could be considered for patients: (1) who are diabetic or intolerant of oral steroids, (2) undergoing extended frontal sinus surgery, and (3) with recurrent stenosis. Given the lack of expert consensus on other key statements, clinicians should carefully consider these treatment options on a case-by-case basis after shared decision-making.